Gambro, the supplier for the CRRT equipment at Cedars-Sinai, has recently informed us of a software defect in its CRRT equipment that will need to be repaired. In the meantime, the safe administration of CRRT requires 24/7 one-on-one staffing by appropriately trained/certified nurses.

Since these nurses are in short supply, we need to be as certain as possible that CRRT will be used only for those patients who have unequivocal indications for its use, and for whom no more appropriate alternative procedure is available.

Based upon recommendations from our leadership in Medicine and Surgery, we will be relying on our colleagues in Nephrology and Critical Care to determine those patients most appropriate for CRRT. Each request for CRRT will be evaluated by Nephrologists and Intensivists using parameters that help define the patient's clinical needs and potential alternatives. The attending physician will be involved in the decision process and will be fully informed about the therapy selected.

We hope that Gambro will be able to resolve the technical problems as soon as possible. Until then, we welcome input from the Medical Staff to be sure we are using CRRT in the best way possible for our patients. Please feel free to contact me directly for any questions or comments you may have.

Paul A. Silka, M.D.
Chief of Staff